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A. Spring Quiz/Exam Comp > APP CVS 1-4 exam > Flashcards

APP CVS 1-4 exam Flashcards

1
Q

Slow conduction through the AV node allows

A

filling of ventricles

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2
Q

what is the effect of carotid massage on HR? Explain

A

carotid massage increases pressure on the carotid artery; increasing stretch and in turn decreases heart rate

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3
Q

Which of the following is the best description of second degree heart block type II (Mobitz II)?

A

A constant PR interval

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4
Q

funky graph we’ve never seen… divided by Systole and Diastole at top; time on x axis

The curve X represents ___

A

Coronary blood flow

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5
Q

Which of the following is INCORRECT regarding coronary artery perfusion?

A

Blood flow is continuous both in systole and diastole

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6
Q

The normal pressure of the Right Ventricle (Point D on graph of circulatory pressures)

A

<25/<5

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7
Q

In ____ an abnormal conduction pathway b/w atrium and ventricle leads to early depolarization of the ventricle.

A

Wolff-Parkinson-white syndrome

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8
Q

Angiotensin-I is converted to angiotensin-II by ACE in __

A

Lungs

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9
Q

During surgery, a 72-year-old patient shows EKG signs of myocardial ischemia with PCWP = 11 mmHg. Blood pressure= 80/40 mmHg and heart rate = 70 bpm.

Describe his treatment.

A

decreased TPR and BP also result in decreased coronary perfusion. fluids should be given, anesthesia depth should be adjusted, and phenylephrine to improve BP and coronary perfusion.

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10
Q

On Ventricle loop image. (A, B, C, D)

Diastole begins at point [X] and ends at point [Y]

A

begins at D and ends at B

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11
Q

The following EKG strip is noted [they’re bradycardic] in a 70-year-old patient who is given 4 mg of neostigmine to reverse blockade. His BP is 90/60 mmHg. The most appropriate course of action in this patient is:

A

Atropine

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12
Q

What phases of ventricular action potential [image given as we’re used to seeing] are exclusively due to movement of potassium out of cell? (SELECT 2 ANSWERS)

A

phases 1 and 3

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13
Q

________ is the most important metabolite to dilate coronary arterioles.

A

Adenosine

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14
Q

Point C indicates ___

[stroke vol/PCWP preload graph - C, A, B]

A

Decrease afterload

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15
Q

What is mechanism of action of Sildenafil ?

A

sildenafil is a PDE 5 inhibitor; blocks the breakdown of GMP to increase relaxation and blood flow to the corpus cavernosum sustaining an erection.

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16
Q

Large cannon wave in CVP records indicates

A

Third degree HB

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17
Q

A 50-year-old man has had fainting “spells” for about 2 weeks. During the fainting episodes, his electrocardiogram shows a ventricular beat of 25 beats/min and 100 P waves per minute. After about 30 seconds of fainting, a normal sinus rhythm recurs. What is his likely diagnosis?

A

Stokes-Adams Syndrome

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18
Q

acethylcholine increases phase ____

SA node AP graph provided; phases 0,3,4

A

Phase 4

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19
Q

A 17-year-old boy is brought to the ER f after being injured in an automobile accident and sustaining significant blood loss. He is given a transfusion of 3 units of blood to stabilize his blood pressure. Which of the following is a consequence of the decrease blood volume in this patient?

A

Increased circulating levels of angiotensin -II

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20
Q

Which of the following is the best description of second degree heart block type I (Wenchebach)?

A

Progressive lengthening of PR interval

21
Q

Arrange the events of ventricular action potential in an order:

A
  1. Rapid upstroke-Fast Na+ channels open, inward Na+ flow
  2. Initial repolarization- K+ channels open, outward K+ flow
  3. Plateau-Ca++ channels open, inward Ca++ flow
  4. Rapid repolarization- K+ channels open more, massive outward K+ flow
  5. Resting membrane potential- high K+ permeability through leaky K+ channels.
22
Q

In cardiac cycle , curve ‘A’ represents ___________________ and curve ‘B’ represents ______________

[weird graph provided; volume pressure on y-axis and time on x-axis; QRS along base… similar to master pressure vol graph]

A

curve a = aortic pressure

curve B =ventricular volume

23
Q

All of the following increase the venous return EXCEPT

Peep
Raised let position
muscle contraction
Respiration

A

PEEP

24
Q

Atenolol (Tenormin) _____________

A

Decreases cAMP level

25
Q

____________ is the largest phase of cardiac cycle.

A

Reduced ventricular filling

26
Q

The ECG tracing shows _________________

A

Atrial Fibrillation

27
Q

The Graph “X” indicates:

RA Pressure
Aortic pressure
LV vol
LV Pressure

A

Right atrial pressure

28
Q

Which of the following drugs blocks angiotensin-II at the receptor?

A

Losartan

29
Q

match the following with their MOA:

  • digitalis
  • verapamil
  • dantrolene
  • norepi
  • quinidine
A
  • digitalis = inhibits Na/K ATPase
  • verapamil = blocks L-type Ca channels (dihydropyrididne receptors)
  • dantrolene = blocks ca release channels (ryanodine receptors)
  • norepi = increases cAMP level
  • quinidine = Na ch blocker
30
Q

the following ekg indicates:

Four vent beats together

A

V Tach

31
Q

Ventricular filling occurs between point [x] to point [y]

on cardiac loop image

A

x= a, y = B

32
Q

‘a’ wave in CVP records indicates __________

A

atrial contraction

33
Q

Lidocaine acts on phase _____

SA node ap graph

A

phase 4

34
Q

Following is the diagram of pacemaker action potential. Norepinephrine ______________________

SA node AP graph

A

Increase the rate of phase 4 depolarization

35
Q

Nitric oxide synthase converts ________ to nitric oxide (NO)

A

arginine

36
Q

Ventricular ejection occurs between point [x] to point [y]

A

x=c

y= d

37
Q

‘c’ wave in CVP records indicates __________

A

right ventricular contraction

38
Q

The ventricles are completely depolarized during which isoelcetric portion of ECG?

A

ST segment

39
Q

The A-V valves (the tricuspid and mitral valves) prevent backflow of blood from _____ during systole, and the semilunar valves (the aortic and pulmonary artery valves) prevent backflow from the ________ during diastol

A

Ventricles to atria; aorta

and pulmonary arteries into the ventricles

40
Q

If the end-diastolic volume is 92 ml and stroke volume is 37 ml. What is patient’s ejection fraction?

A

.40

41
Q

The ventricular repolarization is represented by __________

A

T wave

42
Q

Describe Bainbridge reflex.

A

the bainbridge reflex is the atria’s way of preventing atrial “bursting”. the atrial stretch signals the VMC by the vagus nerve to increase the HR and contraction to push blood forward through the heart.

43
Q

Blood is withdrawn from a 56-year-old man who has a 5-year history of congestive heart failure. Plasma concentrations of angiotensin II, aldosterone, and atrial natriuretic peptide (ANP) are elevated. An increase in which of the following is the most likely explanation for the increase in plasma levels of atrial natriuretic peptide (ANP)?

A

Atrial pressure

44
Q

Describe the formation and significance of dicrotic notch in aortic pressure cure.

A

the dicrotic notch is the aortic valve closing. this is a buffering action for our blood pressure. the absence of this notch there is no buffering and the heart goes straight from systole to diastole - this is seen in atherosclerosis.

45
Q

How blood pressure is affected after carotid endarterectomy (CEA)?

A

after a carotid endarterectomy, blood pressure is high because of the loss of inhibitory feedback on the VMC. there is more sympathetic activity//flow so the bp and hr increase as a result.

46
Q

If a patient undergoing spinal anesthesia experiences a large decrease in arterial pressure and goes into shock, which of the following would be the therapy of choice?

A

Phenylephrine

47
Q

During surgery, a 52-year-old patient shows EKG signs of myocardial ischemia with PCWP = 30 mmHg. Blood pressure= 80/40 mmHg and heart rate = 70 bpm.

Describe his treatment.

A

becuase the pcwp is high and the bp is low, it is not likely hypovolemic but cardiogenic. fluids are inappropriate and an inotrope like dopamine should be used. could also use phenylephrine to increase bp and coronary perfusion. nitroglycerin to decrease venous return. monitor closely

48
Q

Complete dissociation of P wave from QRS

A

Third degree (complete) heart block

49
Q

S3 is produced in:

A

Rapid ventricular filling

A. Spring Quiz/Exam Comp (9 decks)

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